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Check yourself before you wreck yourself

Liam Julian

December 19, 2007

"The popular value of ­­­­­ ­­________ creativity and autonomy as high priorities must give way to a willingness to follow certain carefully prescribed ________ practices."

Replace the first blank with the word "doctor," the second with the word "medical," and you've constructed a commonsense sentence that will garner nods of agreement. Replace the first with "teacher" and the second with "instructional," however, and you've got on your hands a 40-year-old dogfight.

The above sentence is originally found--with the words "teacher" and "instructional"--on the Direct Instruction website. One also finds out on the website "that 32 of 34 qualifying studies demonstrated a positive effect of Direct Instruction on student achievement" and that the practice, which provides teachers with scripted classroom-lessons, is effective in improving academic performance in a bevy of subjects and has a positive effect on students' social skills.

Direct Instruction is not promoted only by its own website, either. Others think highly of the practice (see here, here, here, and here, for example).

Yet, despite the reams of data showing Direct Instruction's effectiveness, the approach remains controversial, in large part because of educators who find its methods stultifying. The practice is being attacked nationally and locally. After administrators in Providence began this year using Direct Instruction in seven of the city's lowest performing elementary schools, Roger Eldridge, a dean at Rhode Island's Feinstein School of Education, told the Providence Journal that teachers would be "jumping through hoops." Others lamented that teachers would lose their ability to be creative in the classroom.

But when doctors use specific, scripted methods, nobody suggests they are "jumping through hoops" or despairs because surgeons can't be "creative" in the OR. It's worth asking: Why do we want our public-school teachers to be "creative"?

Medical training is scientifically-based and prizes results over creativity. Would that this were so in education. A 2006 report from the National Council on Teacher Quality found that, out of 72 randomly selected education schools, only 11 taught all elements of the science of reading. The report's authors wrote, "The decision about how best to teach reading is repeatedly cast as a personal one, to be decided by the aspiring teacher." Reid Lyon, former chief of child development at the National Institutes of Health, has compared such teacher-centered practices to child neglect.

It is foolish to believe that big-hearted 22-year-olds will know, intrinsically, the best way to teach reading to a class of second graders, just as it is foolish to think that newly minted doctors can on their own derive the best way for treating a particular pathology. Surely, though, veteran teachers can teach without rigid, Direct Instruction curricula? Not necessarily. A comparison to the medical profession suggests that even the most grizzled teachers (and their students) may benefit greatly from scripted procedures.

In the December 10th New Yorker,Atul Gawandewrites about the intensive care units of hospitals, which specialize in saving people whose bodies have undergone seemingly untreatable damage. But it isn't easy. A study by Israeli scientists found, Gawande writes, "that the average [I.C.U.] patient required 178 individual actions per day, ranging from administering a drug to suctioning the lungs, and every one of them posed risks." And although the nurses and doctors in the study erred in just one percent of those 178 actions, in such critical situations, even the smallest mistakes can have disastrous consequences.

In 2001, Peter Provonost, a critical-care specialist at Johns Hopkins, decided to try making a basic procedural checklist for I.C.U. doctors. His first list was focused on tackling one problem, line infections, which are common in the I.C.U. and can be deadly. Provonost hypothesized that he could curtail such infections by concentrating on simple practices--washing hands, cleaning the patient's skin, etc.--that might easily be overlooked in hectic I.C.U. environments. He convinced the hospital administration to implement the checklist, and "to authorize nurses to stop doctors if they saw them skipping a step."

After a year with the checklist, "the ten-day line-infection rate went from eleven per cent to zero." In one hospital, "the checklist had prevented some 43 infections and eight deaths, and saved two million dollars in costs."

Direct Instruction attempts to do something similar in schools--to make a checklist of sorts for reading instruction, so the basics don't go overlooked. Certainly a direct comparison between the I.C.U. and the classroom is imprecise; small errors in, say, reading instruction are of course not life-threatening.

Repeated instructional errors do come with a great cost, however, especially for the most at-risk students who don't have access to supplemental help at home and who rely on schools for nearly all their academic learning. If a scripted program can eliminate many of those errors, as Direct Instruction does, why not use it?